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Jean Inman Domain II Part II (Diabetes) (questions and answers).
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Jean Inman Domain II Part II (Diabetes) (questions and answers).
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Jean Inman: Domain II Part II(Diabetes) (questions and
answers)
Type 1
Insulin deficient, patients depend on outside insulin
Type 2
Insulin resistance with relative insulin deficiency (may need insulin)
Acanthosis nigricans
gray-brown skin pigmentation in skin folds; risk factor for diabetes
Normal blood glucose
70-100 mg/dL, 2 hours PG post-prandial <140 mg/dL
Impaired fasting glucose test
FPG - 100-125 mg/dL
Impaired glucose tolerance tese
2h PG - 140-199 mg/dL
Diabetes - fasting plasma glucose
FPG >/= 126 mg/dL or GTT >/= 200 mg/dL
Diabetes indicies
-With symptoms of DM
-Casual plasma glucose >/= 200 mg/dL
-HgA1c >/= 6.5%
GTT curve
Normal - sloped
Diabetes - rounded
Glycosylated/gylcated hemoglobin (HgA1c)
, -Measures % of hemoglobin that has glucose attached; measure of
long term BG control (60-90 days)
-Normal <5.7%
-Over 65 years old; <7% in healthy, </=8% in frail elderly
-Goal for DM <7%
-@ risk for developing DM = 5.7-6.4%
Goals for all diabetics
-Maintain BG average pre-prandial goal 70-130 mg/dL; peak post-
prandial <180 mg/dL
-Optimal serum lipids: LDL <100, TG <150, HDH >40
Male/>50 Female
-BP goal: systolic <130; diastolic <80
-Prevent and treat chronic conditions
-Weight loss if necessary
Strategies for T1DM
1) With fixed daily doses of insulin, consistency of CHO is
recommended
2) Integrate insulin therapy with usual eating habits
3) Monitor BG and adjust insulin doses for amount of food eaten
4) With intensive insulin therapy, adjust pre-meal insulin dosages
based on total CHO content of each meal, using an insulin to CHO
ratio
5) For planned exercise, reduction of insulin may be best
6) Endurance athletes: 120-180 mg/dL is guideline during activity
Risk factors and info for gestational diabetes
Risk if @ BMI >30, hx of GDM
-At 24-28 weeks: screen with 50g GTT; glucose >140 mg/dL = more
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